Use of a Custom-Made Patellar Groove Replacement in an American Staffordshire Terrier Puppy with a Severe Bone Defect in the Femoral Trochlea Caused by Hematogenous Osteomyelitis.

An 8-month-old male American Staffordshire terrier was referred for a no-weightbearing lameness of the right pelvic limb, hyperthermia, lethargy and inappetence. Two months before, endocarditis was diagnosed and treated in another veterinary hospital. Orthopedic, radiographic and tomographic examinations revealed a bone sequestrum of 4 × 1.4 cm and active periosteal reaction of the caudo-lateral cortical in the metaphysis and the distal third of the right femoral diaphysis, medullary osteolysis and interruption of the cranio-medial cortical profile, with involvement of the femoral trochlea leading to a secondary medial patella luxation. Hematogenous osteomyelitis was the suspected diagnosis. Once skeletally mature, after 4 months from surgical debridement and aggressive antibiotic therapy against Klebsiella oxytoca revealed by a bacteriological exam, the patient underwent prosthetic surgery for the application of a custom-made patellar groove replacement (PGR) to fill the bone defect and restore the femoral trochlea surface. Despite the serious injury that afflicted the right pelvic limb, the surgery had satisfactory outcomes until the last 18-month postoperative follow up.

Ultrasound and Elastosonographic Features of the Patellar Ligament in Dogs Affected by Cranial Cruciate Ligament Disease.

This study aims to evaluate the morpho-functional change in the patellar ligament in dogs with cranial cruciate ligament disease. We hypothesized that it may show increased thickening and stiffness with increasing days from onset to diagnosis instead of trauma. Understanding this aspect has implications for the choice of timing for treating patients suffering from cranial cruciate ligament disease, as well as the contextualization of patellar ligament desmitis pictures after surgical treatment with tibial plateau leveling osteotomy or tibial tuberosity advancement. Thirty-three dogs affected by unilateral cranial cruciate disease were examined and divided into three groups based on the time elapsed from the onset of lameness to diagnosis: Group 1 (1-15 days), Group 2 (16-60 days), and Group 3 (over 60 days). Conventional B-mode ultrasonographic and elastosonographic examinations of the patellar ligament were performed without sedation for each dog. Upon ultrasonographic examination, all dogs showed modification in the echostructure of the patellar ligament. In addition, the patellar ligament tended to become harder with increasing days after disease, although there were no significant differences between groups. Our results show that as the time increases between the onset of cranial cruciate ligament disease and diagnosis and treatment, the patellar ligament progressively thickens and loses its elasticity.

Comparative study of 1H-NMR metabolomic profile of canine synovial fluid in patients affected by four progressive stages of spontaneous osteoarthritis.

The study aimed to assess the metabolomic profile of the synovial fluid (SF) of dogs affected by spontaneous osteoarthritis (OA) and compare any differences based on disease progression. Sixty client-owned dogs affected by spontaneous OA underwent clinical, radiographic, and cytologic evaluations to confirm the diagnosis. The affected joints were divided into four study groups based on the Kallgreen-Lawrence classification: OA1 (mild), OA2 (moderate), OA3 (severe), and OA4 (extremely severe/deforming). The osteoarthritic joint's SF was subjected to cytologic examination and 1H-NMR analysis. The metabolomic profiles of the study groups' SF samples were statistically compared using one-way ANOVA. Sixty osteoarthritic joints (45 stifles, 10 shoulders and 5 elbows) were included in the study. Fourteen, 28, and 18 joints were included in the OA1, OA2, and OA3 groups, respectively (0 joints in the OA4 group). Metabolomic analysis identified 48 metabolites, five of which were significantly different between study groups: Mannose and betaine were elevated in the OA1 group compared with the OA2 group, and the 2-hydroxyisobutyrate concentration decreased with OA progression; in contrast, isoleucine was less concentrated in mild vs. moderate OA, and lactate increased in severe OA. This study identified different 1H-NMR metabolomic profiles of canine SF in patients with progressive degrees of spontaneous OA, suggesting 1H-NMR metabolomic analysis as a potential alternative method for monitoring OA progression. In addition, the results suggest the therapeutic potentials of the metabolomic pathways that involve mannose, betaine, 2-hydroxyisobutyrate, isoleucine, and lactate.

Effects of Autologous Microfragmented Adipose Tissue on Healing of Tibial Plateau Levelling Osteotomies in Dogs: A Prospective Clinical Trial.

The aim of this study was to evaluate the effects of autologous microfragmented adipose tissue (MFAT) applied after mechanical fragmentation and assess these effects radiographically in bone healing in dogs subjected to tibial plateau levelling osteotomy (TPLO). Twenty dogs with unilateral cranial cruciate ligament disease were enrolled and randomly assigned to the treatment group (MFAT) or the control group (NT). The MFAT group underwent TPLO and autologous MFAT intra-articular administration, while the NT group underwent TPLO alone. Adipose tissue was collected from the thigh region, and MFAT was obtained by mechanical fragmentation at the end of the surgery. The patients were subjected to X-ray examination preoperatively, immediately postoperatively (T0), and at 4 (T1) and 8 (T2) weeks postoperatively. Two radiographic scores that had previously been described for the evaluation of bone healing after TPLO were used. A 12-point scoring system (from 0 = no healing to 12 = complete remodelling) was used at T0, T1, and T2, while a 5-point scoring system (from 0 = no healing to 4 = 76-100% of healing) was used at T1 and T2. The median healing scores were significantly higher at T1 and T2 for the MFAT group compared with the NT group for the 12-point (p < 0.05) and 5-point (p < 0.05) scoring systems. The intra-articular injection of autologous microfragmented adipose tissue can accelerate bone healing after TPLO without complications.

Surgical Repair of Luxation of the Superficial Digital Flexor Tendon in Dogs Using a Calcaneal Chondroplastic-like Technique-Three Cases.

The purpose of this report is to describe the technique and the clinical outcome of three dogs affected by superficial digital flexor (SDF) tendon luxation treated using a calcaneal chondroplastic-like technique. A German Pinscher with bilateral and lateral SDF tendon luxation, a Griffon Nivernais with medial SDF tendon luxation following self-mutilation of the IV toe, and an American Staffordshire Terrier with a lateral luxation and having undergone calcaneal chondroplasty and primary repair of the retinacular tissues. A fibrocartilage flap covering the calcaneal groove was elevated, the subchondral bone was removed from beneath it, and the flap was pressed back into the deepened sulcus, keeping its distal attachment as a hinge point. The SDF tendon was reduced, and its tracking along the deepened groove was ensured. Furthermore, the torn retinacular attachment was repaired. Clinical follow-ups at 4 and 8 weeks and 1 year apart showed no signs of lameness and no SDF tendon re-luxation. The calcaneal chondroplastic-like technique led to a satisfactory outcome with no complications. This technique is relatively straightforward, requires no implants, and is also successful without postoperative immobilization of the tarsal joint. Further cases are required to determine its benefits and its risks compared to conventional surgery.

Effects of Intra-Articular Autologous Adipose Micrograft for the Treatment of Osteoarthritis in Dogs: A Prospective, Randomized, Controlled Study.

The purpose of this study was to estimate the safety, feasibility, and efficacy of the intra-articular treatment of autologous microfragmented adipose tissue in dogs with spontaneous osteoarthritis (OA) in comparison with hyaluronic acid (HA), the standard intra-articular treatment. Specifically, it clinically evaluated pain and lameness, the radiographic progression of osteoarthritis, and synovial fluid inflammation. This was a prospective, single-center, parallel-group, randomized, controlled, in vivo clinical study. Participants (n = 40) received either a single intra-articular injection of microfragmented adipose tissue or a single intra-articular injection of HA (1:1). Clinical outcomes were determined using a specialistic clinician assessment obtained by the completion of a specific clinical form based on the Vesseur modified lameness classification system, a pain evaluation using the Visual Analogue Scale (VAS), the measurement of the range of motion (ROM) of the affected joint, limb circumference, and the owners' score evaluation using the Canine Brief Pain Inventory (CBPI) for up to 6 months after the time of injection. Patients underwent a radiographic examination to establish the degree of OA in the affected joint, and synovial fluid samples were collected to assess the biochemical environment of the joint and evaluate and quantify the cellular population and the presence of three specific inflammation biomarkers for up to 60 days. The results of this study suggest that microfragmented autologous adipose tissue is safe and can effectively relieve pain and improve function in dogs with spontaneous articular OA. This one-step procedure is simple, timesaving, cost-effective, minimally invasive, and eliminates the need for complex and time-intensive cell culture processing. Furthermore, the clinical evidence and cytological results suggest better long-term pain control, resulting in an improvement in joint function, compared to HA treatment. The canine spontaneous OA model could play a key role in developing successful treatments for human medicine.

Clinical and Radiographic Evaluation of Short- and Long-Term Outcomes of Different Treatments Adopted for Elbow Medial Compartment Disease in Dogs.

Medial compartment disease is a common occurrence in dogs affected by elbow dysplasia. Despite many treatments suggested in the literature, only few studies reported comparative outcomes in the short and long term. The aim of this study is to report and compare short- and long-term clinical and radiographic outcomes of dogs treated for medial compartment disease (MCD) by distal dynamic ulnar ostectomy (DUO), bi-oblique dynamic proximal ulnar osteotomy (BODPUO) and conservative management (CM). From 2016 to 2018, all medium to large dogs, aged between 5 and 12 months, affected by uni/bilateral MCD and treated by DUO, BODPUO or CM, were enrolled in this study and followed up for 24 months. Orthopedic and radiographic examinations were performed at T0, T2, T12 and T24 months after treatment. Lameness score, elbow arthralgia, elbow range of motion (ROM), osteoarthritis (OA) score and percentage of ulnar subtrochlear sclerosis (%STS) were evaluated at each time point. According to the treatment performed, dogs were divided into three groups: DUO, BODPUO and CM. Forty-five elbows from twenty-six dogs, treated with DUO (n = 17), BODPUO (n = 17) or CM (n = 11), were prospectively enrolled in the study. The patients enrolled in the CM group were older and showed more severe radiographic signs of OA, compared to those enrolled in the other two groups. Lameness and arthralgia scores (p < 10-4) were significantly decreased in patients that underwent surgical treatment and increased in patients managed conservatively (lameness p < 10-4, arthralgia p = 0.3068), at T12 and T24. OA score (p < 0.0040) and ROM (DUO, CM p < 10-4; BODPUO p = 0.0740) worsened in every study group, but %STS decreased in DUO (p = 0.0108), increased in the CM group (p = 0.0025) and remained unchanged in the BODPUO group (p = 0.2740). This study supports the clinical efficacy of DUO and BODPUO in reducing lameness, arthralgia and progression of %STS. Early diagnosis and surgical attention in patients affected by MCD can improve the short- and long-term outcome and reduce the progression of secondary changes.